1538405139 NPI number — MRS. KAITLIN MICHELLE KNAPP FNP

Table of content: MRS. KAITLIN MICHELLE KNAPP FNP (NPI 1538405139)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538405139 NPI number — MRS. KAITLIN MICHELLE KNAPP FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KNAPP
Provider First Name:
KAITLIN
Provider Middle Name:
MICHELLE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WALDRON
Provider Other First Name:
KAITLIN
Provider Other Middle Name:
MICHELLE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
FNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1538405139
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/11/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
431 FRANKLIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RUMFORD
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04276-2100
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-364-7831
Provider Business Mailing Address Fax Number:
207-369-9467

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
431 FRANKLIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RUMFORD
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04276-2100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-364-7831
Provider Business Practice Location Address Fax Number:
207-369-9467
Provider Enumeration Date:
12/31/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  CNP121120 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)